20 13 FRENCH INSTITUTE FOR PUBLIC HEALTH SURVEILLANCE SUMMARY of the annual report
2013 Highlights Triple-S: A European project for syndromic surveillance A more strategic COP for 2014-2017 The Contrat d objectifs et de performance (Objectives and Performance agreement, COP) for 2014-2017, approved on 22 November 2013 by InVS Board of Directors has the ambition to increase the readability of the Institute s strategy in the medium and long term, and definitely stands within the Social Affairs Inspectorate (IGAS) guidelines framework. In a context marked by the evolution of public health risks, and by the necessary search for efficiency in public expenses, the COP 2014-2017 is structured around four priorities. It thus establishes monitoring indicators and calls for a review of the InVS organization to strengthen its role as governmental support. Develop our expertise in France and abroad International Collaborations: welcoming foreign delegations Enhancing the ability of European countries to develop reactive monitoring systems has become a necessity to deal with cross-border health threats and meet the growing demand for responsive information from health authorities. With the ultimate objective to improve the ability to detect and monitor the impact of these events on human and animal health at European level, the Triple-S European project (Syndromic Surveillance Survey, Assessment towards guidelines for Europe) started in 2010 for a period of three years. Co-funded by the European Commission, it brought together 24 organizations from 13 countries. Monitoring and supervision: The InVS Day Nearly 360 participants gathered on 11 April 2013 to participate in the traditional InVS Day (JINVS) program on major public health issues. The place was packed with attendees especially during the roundtable entitled 10 Years After the Heatwave, the Monitoring Tested by the Crisis, which presented the contribution of monitoring and surveillance in the decision-making process and to review the experience derived from the crisis. As part of InVS missions, a reception of foreign delegations was hosted to best meet the expectations of public health institutes and ministries of health wanting to know about the organization of monitoring, alert and surveillance in France, and better understand the activities, methods and systems developed by the Institute. These meetings allowed to discuss health systems organizational matters, public health and safety issues, as well as the role of institutions in charge of public health and safety, and their scientific and technological resources.
355,000 new cases of cancer in France in 2012 Monitor the French population through large studies Alzheimer s disease and related dementias (MAAD) According to a study conducted by InVS from different databases (long-term health conditions, hospitalizations, death) in 2010, 316,115 people presented a long term disease associated with Alzheimer s disease and related dementia (MAAD) (ALD15); 228,190 people were hospitalized and 54,291 died from a MAAD. Between 2007 and 2010, the number of people under ALD15 (long-term health conditions) increased by 14.6%, the number of people hospitalized for MAAD by 23.6% and the number of deaths from MAAD by 13.9%. These results highlight the considerable weight and increase of MAAD in our society. Cancer: primary cause of mortality An updated study on the evolution of cancer mortality incidence was published in July 2013. Based on data from the French network of cancer registries (FRANCIM), the 1980-2012 trends were analyzed for 19 solid tumors and 15 hematological malignancies. The number of new cases of cancer in France in 2012 was estimated at 355,000 with 35,000 new cases of malignancies estimated in France that same year, a tenth of the new cancer cases. Using medicoadministrative databases More than a dozen projects are currently underway with data collected from the Système national d informations inter-régimes de l Assurance maladie (National Information and Social Security System, SNIIRAM); all are interested in the fields covered by the InVS. Based on this experience and considering its missions, in July 2013 InVS was granted full and permanent access to the SNIIRAM, equivalent to the social security funds. lités Reports nquiry Database Surveillance Ass Proje
Diet and nutritional status of people benefiting from food aid Asbestos: Occupational exposure of retired craftsmen/artisans The first edition of the Abena study conducted by InVS in 2004-2005 on the populations benefiting from food aid contributed for the first time to learn about their food consumption and nutritional status. The study was repeated in 2011-2012, according to a similar protocol, to update this information and measure changes since 2004-2005. It shows that among the beneficiaries of food aid, 51% have benefited from it for more than 2 years in 2011-2012, while they were 34.5% in 2004-2005. InVS and the Régime social des indépendants (Social Security Fund for Independent Workers, RSI) launched in 2005 The French National Program for Post-occupational Surveillance of Workers Exposed to Asbestos (ESPrI), following up retired craftsmen/artisans exposed to asbestos during their career, in order to improve the knowledge of the health impact of such exposition. In this program, 65% of men and 3% of women were estimated as exposed to asbestos at least once during their career. This frequency is higher than among the retirees from the general social security fund (for employed people). This is explained by the type of occupational activities craftsmen/artisans are involved in and demonstrates the importance of a specific medical follow-up for the concerned retired population. Cover several fields of surveillance and alert the authorities MERS-CoV: France is affected by two cases In France, two people infected with MERS-CoV were identified in May 2013. The first person had spent his holidays in the United Arab Emirates within 14 days before clinical signs. The investigations around this person identified, among the people with whom he had been in contact, another MERS-CoV case, revealing a first transmission on the French territory. The measures implemented during this episode helped stop the transmission. A press conference was held at the InVS in which Marisol Touraine, Minister of Social Affairs and Health, met with the teams and visited the operational crisis center. Suicide mortality in farmers and growers According to a first InVS analysis conducted from data provided by the Caisse centrale de mutualité sociale agricole (Central Fund for Agricultural Social Security, CCMSA), excess suicide mortality was observed in 2008 and 2009 among farmers and growers (about 35 suicides/100,000 people/year compared to 25/100,000 people/year in the general population). A study is being conducted for 2010 and 2011. Pesticides and PCBs - NDL: Exposition of the French population Within the Framework of an environmental chapter considered in the Etude nationale nutrition santé (National Health and Nutrition Survey, ENNS), conducted between 2006 and 2007, InVS studied exposure biomarkers (measurement of pollutants or their by-products in blood, urine, hair...) certain metals, non-dioxin polychlorinated biphenyls (NDL-PCB) and three families of pesticides. For the first time in France, their concentrations in serum and urine were measured in 400 people (aged 18-74), representative of the French adult population.
InVS stands at the heart of public health issues A warning role Éric Aubry Chairman of the board of directors Françoise Weber General Director As a Public institution, under the supervision of the French Ministry of Health, the French Institute of Public Health Surveillance (InVS) provides a cross mission that consists in monitoring and providing epidemiological surveillance, alerting and contributing to crisis management and, in all fields of public health: infectious diseases, chronic diseases, traumatisms, environmental health and occupational health. To carry out its missions, InVS collects public health information from multiple healthcare stakeholders through organized and on-going collection of data related to diseases or known risks (cancer, HIV, influenza, etc.). InVS also relies on tools for collecting non-targeted information to identify unusual events not covered by a health monitoring system. The objective is to detect threats to health as early as possible, and identify emerging risks - using data ranging from non-specific monitoring (stays in emergency units) to sites monitoring and international data matching. InVS has developed over 300 partnerships and coordinates various health monitoring networks in France such as the Centres nationaux de référence (National Reference Centres, CNR), the morbidity registers, or hospital-acquired infections networks. This spearhead and networks facilitator function is essential to gather as much relevant information as possible and allow InVS to perform its surveillance function. On-going surveillance of the population Collection and analysis of epidemiological data collected continuously by InVS are the key elements to provide answers to new issues and health challenges. The data collected by InVS are analyzed, interpreted, translated and put in perspective in the form of bulletins, notices, reports, articles, notes and methodological guides. The objective is to increase knowledge on human health, inform professionals as well as the authorities in their public health-related decision-making. This process is conducted with the aim of providing ongoing research with a high level of scientific quality and responsiveness to respond to the requirements of public policy. In this context, InVS is committed to continuously assess its overall monitoring system to keep a good level of efficiency that continues to reflect the national public health priorities. This strategic orientation is conducted with the assistance of the Scientific Council of the Institute and of the Comité collégial d évaluation des projets (Project Evaluation Committee, CCEP) established within the Institute. A guaranteed continuum in the French Regions thanks to the CIRE To carry out its missions throughout the national territory, InVS relies on a network of offices in various French regions: the CIRE. Located within the Agences régionales de santé (Regional Health Agencies, ARS) in 15 regions or inter-regions in mainland France and the French overseas (French West Indies- French Guiana and French territories in the Indian Ocean), 17 CIRE undertake the surveillance of the populations health status in those territories and play a major role in the management of health crises locally. The CIRE programmed activities are organized in a way that is consistent with the scientific InVS departments, taking into account the regional needs and requests made by the ARS. In addition, regional action is involved on the monitoring of notifiable diseases (MND). Coordinated actions with public health actors InVS endeavors to promote the exchange and sharing of data for epidemiological purposes. Given its cross-purpose and advanced surveillance functions in all issues related to human health, the Institute develops joint programs with most of the public actors in the health field: health agencies, various social security funds, public institutions, like the French Institute of Health and Medical Research (INSERM), The National institute for demographic studies (INED), etc.
Observe, Monitor, Alert 17 regional epidemiology units (Cellule Interrégionale d épidémiologie - CIRE) 60 million EUR in operation / INVS PUBLICATIONS BEH (Bulletin épidémiologique hebdomadaire) 425 employees in 2013 The Weekly Epidemiologic Bulletin (BEH) is a peer reviewed journal published by InVS, which provides articles submitted by all public health stakeholders. The FRENCH Institute for Public Health Surveillance (InVS) is a public administrative institution under the supervision of the French Ministry of Health. A universal field that covers all the areas of human health: infectious diseases, the environment s impact on health, occupational hazards, chronic diseases, traumatisms and international risks. A priority objective: using public decision in the interest of the health of populations. [1] Articles L.1413-2 and L.1413-3 PE (Point épidémiologique) PE is a feedback tool. Its regular publication facilitates the regional network. View the full version of InVS 2013 Annual Report on InVS website (in French only): www.invs.sante.fr Reports and executive summaries The scientific report is the reference publication of any new study. It is a detailed document often available as an executive summary. All publications are available online at: http://www.invs.sante.fr/publications-et-outils / Under the Code of Public Health [1], InVS missions are to: Monitor and observe the health status of the population on a permanent basis. Provide health-related surveillance and alertness, including international surveillance: detection of emerging risks, monitoring the most vulnerable or endangered populations. Alert authorities in case of risk to human health and provide support for crisis management. BVS (Bulletin de veille sanitaire) The BVS is a regional bulletin published by the regional epidemiology units (CIRE) that presents the results of local studies and investigations. Edited by InVS Coordination: InVS Communication Department Writing: Technoscope Design: www.kazoar.fr - 01 53 06 32 22 Copyright: Dircom/CE, Jean-François Baumard, Thinkstock, Fotolia. ISBN : 979-10-289-0094-6 ISBN NET: 979-10-289-0095-3 ISSN: 1630-828X November 2014